title: [Efficacy and safety of botulinum toxin in external urethral sphincter by transperineal way guided transrectal ultrasound and electromyography on chronic urinary retention due to spinal cord injury].
abstract: BACKGROUND
  To assess the efficacy and safety of botulinum toxin for sphincter hypertonia in patients with spinal cord injury (SCI).
  
  
  METHODS
  Non-control clinical trial on men with neurogenic detrussor-sphincter dyssynergia (DSD) due to SCI. 100 IU of Botox® were injected through the transperineal way on external urethral sphincter under electromyography and transrectal ultrasound guidance. The following parameters were determined: post-void residual (PVR), maximum urethral pressure (MUP), miction volume (M) and miction percentage (MP). The incidence of erectile dysfunction was evaluated using the International Index of Erectile Function questionnaire (IIEF-5 items).
  
  
  RESULTS
  19 men with an average age of 40 years (ED 22-56) were included. The average time of monitoring was 546 days (20 months). As an average, an infiltration was done every 6 months, with an average of 2.7 infiltrations per patient (1-7). PVR dropped by 59.3 ml, p=0.03; miction raised to 52 ml, p=0.018; MP was improved by 17.2%, p=0.011. Changes on MUP were not significant. Erectile dysfunction was not worse than the initial one (IIEF-5: 11.4 to 13).
  
  
  CONCLUSIONS
  The infiltration of the toxin into the sphincter through the transperineal way seems to be an effective and safe therapeutic option.
authors.affiliation: Servicio de Medicina Física y Rehabilitación, Fundación Althaia, Manresa, Barcelona, España. gromero@althaia.cat
authors.forename: Georgia
authors.initials: G
authors.lastname: Romero-Cullerés
authors.forename: Joan
authors.initials: J
authors.lastname: Conejero-Sugrañes
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: González-Viejo
authors.forename: Jose
authors.initials: J
authors.lastname: Bruno-Montoro
authors.forename: Pilar
authors.initials: P
authors.lastname: López-Guillen
authors.forename: Montse
authors.initials: M
authors.lastname: Abenoza-Guardiola
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D004576:Electromyography; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000502:physiology; D016055:Urinary Retention / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A